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SDG 3: HIV/AIDS

Abstract

Background

Late HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.

Aim

To determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.

Methods

This multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019–21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.

Results

Among 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.

Conclusion

MOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2024.29.48.2400138
2024-11-28
2024-11-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.48.2400138
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Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Sotirios+Roussos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Roussos Sotirios</a>, <a href="/search?value1=Nikos+Pantazis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pantazis Nikos</a>, <a href="/search?value1=Konstantinos+Protopapas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Protopapas Konstantinos</a>, <a href="/search?value1=Anastasia+Antoniadou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Antoniadou Anastasia</a>, <a href="/search?value1=Antonios+Papadopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papadopoulos Antonios</a>, <a href="/search?value1=Giota+Lourida&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lourida Giota</a>, <a href="/search?value1=Vasileios+Papastamopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papastamopoulos Vasileios</a>, <a href="/search?value1=Maria+Chini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chini Maria</a>, <a href="/search?value1=Konstantinos+Alexakis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Alexakis Konstantinos</a>, <a href="/search?value1=Emmanouil+Barbounakis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Barbounakis Emmanouil</a>, <a href="/search?value1=Diamantis+Kofteridis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kofteridis Diamantis</a>, <a href="/search?value1=Lydia+Leonidou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Leonidou Lydia</a>, <a href="/search?value1=Markos+Marangos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marangos Markos</a>, <a href="/search?value1=Vasileios+Petrakis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petrakis Vasileios</a>, <a href="/search?value1=Periklis+Panagopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Panagopoulos Periklis</a>, <a href="/search?value1=Elpida+Mastrogianni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mastrogianni Elpida</a>, <a href="/search?value1=Dimitrios+Basoulis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Basoulis Dimitrios</a>, <a href="/search?value1=Panagiota+Palla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Palla Panagiota</a>, <a href="/search?value1=Nikolaos+Sipsas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sipsas Nikolaos</a>, <a href="/search?value1=Varvara+Vasalou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vasalou Varvara</a>, <a href="/search?value1=Vasileios+Paparizos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Paparizos Vasileios</a>, <a href="/search?value1=Simeon+Metallidis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Metallidis Simeon</a>, <a href="/search?value1=Theofilos+Chrysanthidis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chrysanthidis Theofilos</a>, <a href="/search?value1=Ioannis+Katsarolis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Katsarolis Ioannis</a>, <a href="/search?value1=Vana+Sypsa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sypsa Vana</a>, <a href="/search?value1=Mina+Psichogiou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Psichogiou Mina</a></span>. Missed opportunities for early HIV diagnosis in Greece: The MORFEAS study, 2019 to 2021. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(48):pii=2400138. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.48.2400138" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.48.2400138</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 28 Feb 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 27 Jul 2024 </span> </p>
/content/10.2807/1560-7917.ES.2024.29.48.2400138
/content/10.2807/1560-7917.ES.2024.29.48.2400138
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